tci Medicare Compliance & Reimbursement - 2006 Issue 21

AUDITS: Keep An Eye On The Charts Requested by 'Bounty Hunters'

If the RACs recycle your appealed claims, contact CMS.The Recovery Audit Contractors (RACs), which have been looking at just hospital claims, are starting to look at physician claims now. If you're in New York, Florida or California, they could soon be on your doorstep. Providers refer to RACs as "bounty hunters" because they only make money if they collect Medicare overpayments from you. They also will receive financial incentives if they find underpayments.Problem: The RACs aren't supposed to look at claims that your carrier already denied and then paid on appeal. But several Florida providers have received...

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